Page 257 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: The application of the stockinette must be wrinkled free. Wrinkles can cause ulcers to the
skin and cause further injury to the patient.
a. Place patient's injured leg on the orthopaedic bump with ankle at a 90 degree angle to the
tibia.
NOTE: There are several ways to obtain a 90 degree angle. The patient could maintain the position,
nursing personnel or family member can assist, a T stand, or thigh stand could be used, or the patient
could be placed in the prone position It is the technician preference.
b. Hold open the sides of the stockinette.
c. Instruct patient to place injured foot in the opening.
d. Roll stockinet on the injured leg 1 inch past the phalanges to 3 inches proximal to the
knee.
NOTE: Rolling the stockinette on promotes a better fit.
e. Pinch the stockinette at the base of the ankle and make a 1/2 inch cut at a 45 degree angle
and seal it with paper tape.
f. Fold over the distal edge of the stockinette and tape it down.
12. Measure patient's injured ankle with goniometer.
NOTE: All short leg walking casts( SLWC ) are applied in neutral position (90 degrees dorsiflexion)
absent of inversion and eversion, unless otherwise indicated by physician's order.
a. Place the stationary arm of the goniometer in horizontally, bisecting the fibula
b. Place the moving arm of the goniometer in a vertically , bisecting the lateral side of the 5th
phalange.
c. Place the protractor of the goniometer on the malleolus
d. Set wrist until the goniometer measures 90 degrees of dorsal flexion.

13. Apply felt to injured ankle/leg.(Refer to Figure 3-x).

13
Padding applied to diabetic leg

a. Apply a 3 inch wide strip to the anterior aspect of the leg from the dorsum of the toes to the
tibial tuberosity.
b. Cut two circular pieces of felt to cover both the medial and lateral malleolus
c. Apply felt across the tips of the toes from the dorsum to plantar surface of the foot.
d. Tape all felt padding to stockinette.
14. Prepare casting materials.
a. If using fiberglass casting materials go to step 15.
b. If using plaster casting materials go to step 17.

15. Place fiberglass casting gloves on hands.
Caution: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns while applying a fiberglass cast.
16. Open fiberglass casting package and go to step 18.
NOTE: Open one fiberglass package at a time. As fiberglass roll comes in contact with the air, the roll
will start to cure and harden.
17. Open and remove (3) plaster rolls from their packages and place on work cart/station.
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